Key result
Recurrent mitral regurgitation after surgical or transcatheter mitral valve repair was associated with a significantly increased risk of reoperation (OR 11.76) compared to no recurrence.
Why the study?
The study was conducted to summarize available evidence on the impact of recurrent mitral regurgitation on clinical outcomes after surgical or transcatheter intervention.
Does recurrent mitral regurgitation worsen clinical outcomes in patients who underwent surgical or transcatheter mitral valve repair?
Meta-Analysis (n=5,804)
Does recurrent mitral regurgitation worsen clinical outcomes in patients who underwent surgical or transcatheter mitral valve repair?
Recurrent moderate-to-severe mitral regurgitation after surgical or transcatheter repair is associated with significantly increased risks of reoperation, cardiovascular death, readmission, and heart failure.
Recurrent MR signals higher reoperation and mortality risk; leaves open whether preventing recurrence improves outcomes in primary versus secondary MR.
BACKGROUND: Recurrent mitral regurgitation (MR) is typically defined as MR that is moderate or severe on follow-up echocardiography after the intervention. This meta-analysis summarizes the results of all available studies on the impact of recurrent MR on clinical outcomes after the intervention. METHODS: Medline, EMBASE, PubMed and Web of Science were searched from January 2000 to August 2024 for original studies reporting outcomes about the clinical impact of recurrent MR. Five clinical outcomes were analysed: reoperation, cardiovascular deaths, readmission, heart failure and New York Heart Association (NYHA) functional classification. The summary odds ratio (OR) with the 95% confidence interval (CI) was used to assess the risk of clinical outcomes. RESULTS: A total of 22 studies were included in the final analysis, involving 5,804 patients, of which 960 had recurrent MR. The overall pooled incidence of recurrent MR is 16.54%. Secondary or primary patients with MR with recurrent MR after an intervention had higher rates of reoperation [(OR = 6.25, 95% CI, 2.95-14.41; P < 0.001) or (OR = 22.54, 95% CI, 14.96-33.98; P < 0.001)]or of cardiovascular death [(OR = 5.26, 95% CI, 2.35-11.77; P < 0.001) or (OR = 1.68, 95% CI, 1.32-2.14; P < 0.001)]. The rates were also high for readmission (OR = 3.95, 95% CI, 2.56-6.10; P < 0.001), heart failure incidence (OR = 2.87, 95% CI, 1.75-5.11; P < 0.001) and the number of NYHA functional class III/IV (OR = 5.40, 95% CI, 3.01-9.70; P < 0.001) for recurrent MR of secondary MR. However, no significant association was found between recurrent MR of primary MR and the incidence of NYHA functional class III/IV (OR = 1.02, 95% CI, 0.47-2.22; P = 0.96). CONCLUSIONS: Recurrent MR is associated with higher rates of reoperations, readmissions, cardiovascular deaths, incidences of heart failure and NYHA functional class III/IV numbers. However, recurrent MR of primary MR is not correlated with NYHA functional class III/IV.
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Rad et al. (2025) conducted a meta-analysis in Mitral regurgitation (n=5,804). Recurrent mitral regurgitation vs. No recurrent mitral regurgitation was evaluated on Reoperation (OR 11.76, 95% CI 5.64-24.49, p=<0.001). Recurrent mitral regurgitation after surgical or transcatheter mitral valve repair was associated with a significantly increased risk of reoperation (OR 11.76) compared to no recurrence.
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